Sonographic assessment of arterial frequency and distribution within the brachial plexus: a comparison with the cadaveric record

We investigated the number and distribution of arteries within the brachial plexus territory using a portable ultrasound device, and compared these findings with known cadaveric data. We recruited 200 volunteers and carried out 400 brachial plexus examinations in a prospective observational study design. We identified arteries within the brachial plexus in more than 90% of subjects. Most of these were located in the upper and middle zones of the plexus and therefore lie within the possible path of a block needle. These findings correlate well with previous cadaveric studies, suggesting that arteries within the brachial plexus territory can be reliably identified with a portable ultrasound device. The presence of these vessels may impact upon the safety and efficacy of brachial plexus blockade. Routine pre-procedural sonographic assessment may offer improved safety and efficacy. You can respond to this article at http://www.anaesthesiacorrespondence.com.